评估一种多药化疗方案（CMOP）（包括长春新碱、环磷酰胺、米托蒽醌和泼尼松龙）对治疗家猫中大细胞淋巴瘤的效果

摘要来源：

一校：刘玲

二校：kenda

编辑：百可事乐

摘要

本研究的目的是确定使用长春新碱、环磷酰胺、米托蒽醌和泼尼松龙（CMOP）方案治疗猫中大细胞淋巴瘤的有效率、中位无进展期（PFI）和中位生存期（MST）。次要目标是确定在该多药方案中米托蒽醌的耐受性。

对2009年至2022年间在同一机构接受治疗的31只猫的病历进行回顾，以筛选合适病例。将满足以下条件的猫纳入研究：确诊为中大细胞淋巴瘤，接受过CMOP方案作为一线治疗，且至少完成一个为期4周的治疗周期。方案允许的调整包括：使用L-天冬酰胺酶、用长春花碱代替长春新碱、用苯丁酸氮芥代替环磷酰胺、以及用地塞米松或甲泼尼龙代替泼尼松龙。

总有效率为74%（n=23），其中45%（n=14）完全缓解（CR），29%（n=9）部分缓解（PR），26%（n=8）病情稳定（SD）。Kaplan-Meier分析显示中位PFI和中位MST分别为139天和206天。与无效组相比，有效组（CR或PR）的中位PFI和中位MST均显著延长（P<0.001）（分别为176天VS 62天和251天VS 61天）。达到CR的猫的中位PFI和MST显著延长（P<0.001），分别为178天和1176天。达到CR的猫的6个月、1年和2年生存率分别为64%、57%和35%。米托蒽醌治疗总体耐受良好，所有猫均未出现高于2级的兽医合作肿瘤学组不良反应。

CMOP方案是治疗猫中大细胞淋巴瘤的一种替代性且耐受性良好的治疗方法。正如先前的化疗方案所证明的那样，对治疗有反应的猫，尤其是达到CR的猫，可能会获得更持久的效果。

原文：

Evaluation of a multiagent chemotherapy protocol combining vincristine, cyclophosphamide, mitoxantrone and prednisolone (CMOP) for treatment of feline intermediate–large cell lymphoma

Abstract

Objectives

The aim of this study was to determine response rates, median progression-free intervals (PFIs) and median survival times (MSTs) for cats with intermediate–large cell lymphoma treated with a vincristine, cyclophosphamide, mitoxantrone and prednisolone (CMOP) protocol. A secondary objective was to determine the tolerability of mitoxantrone used within this multiagent protocol.

Methods

The medical records of 31 cats treated at a single institution between 2009 and 2022 were reviewed to identify suitable cases. Cats were included in the study if they had a confirmed diagnosis of intermediate–large cell lymphoma, had received a CMOP protocol as first-line treatment and had completed at least one 4-week cycle of this protocol. Modifications allowed in the protocol included the use of l-asparaginase, vinblastine substitution for vincristine, chlorambucil substitution for cyclophosphamide and dexamethasone or methylprednisolone substitution for prednisolone.

Results

The overall response rate was 74% (n = 23), with 45% (n = 14) achieving complete remission (CR), 29% (n = 9) achieving partial remission (PR) and 26% (n = 8) achieving stable disease (SD). The Kaplan–Meier median PFI and MST were 139 days and 206 days, respectively. Responders (CR or PR) had a significantly longer (P <0.001) median PFI and MST compared with non-responders (SD) (176 days vs 62 days, and 251 days vs 61 days, respectively). Cats that achieved CR had a significantly longer median PFI and MST (P <0.001) at 178 days and 1176 days, respectively. The 6-month and 1- and 2-year survival rates in cats with CR were 64%, 57% and 35%, respectively. Treatment with mitoxantrone was generally well tolerated, with no cats experiencing Veterinary Cooperative Oncology Group adverse effects above grade 2.

Conclusions and relevance

The CMOP protocol is an alternative and well-tolerated treatment for cats with intermediate–large cell lymphoma. As demonstrated with previous chemotherapy protocols, cats that respond to treatment, particularly those that achieve CR, are likely to have more durable responses.